MSK upper limb Flashcards
(148 cards)
1
Q
Describe the axilla
A
A pyramidal space below the shoulder joint
2
Q
At which anatomical point does the axillary artery begin
A
Lateral border of 1st rib
3
Q
The axillary artery continues beyond the axilla as which vessel
A
Brachial artery
4
Q
Which ropes form the brachial plexus
A
Ventral rami of C5 to T1
5
Q
Which nerve roots form the upper trunk
A
C5 and C6
6
Q
Which roots of the plexus contribute to the lower trunk
A
C8 and T1
7
Q
Which root forms the middle trunk
A
C7
8
Q
What is caused by injury to upper trunk
A
Erbs palsy- waiters tip- medial rotation of the arm with wrist flexion
9
Q
What is caused by injury to the lower trunk
A
Klumpkes palsy - claw hand
10
Q
Where does the axillary nerve originate
A
Posterior cord of C5/c6
11
Q
Where does the radial nerve orginate
A
Posterior cord C5/c6/c7/c8/t1
12
Q
Where does the musculocutaneous nerve orginate
A
Lateral cord C5/c6/c7
13
Q
Where does the ulnar nerve orginate
A
Medial cord c8/t1
14
Q
Where does the median nerve orginate
A
Lateral and medial cord C5/c6/c7/c8/t1
15
Q
What is the dorsal venous arch
A
Complex network of veins lying at the distal aspect of the upper limb
16
Q
What is the median cubital vein
A
Large communicating vein which shunts blood from the cephalic vein to the basilic vein
17
Q
Describe the cephalic vein
A
Ascends the arm on its lateral aspect, piercing the clavipectoral fascia draining into the axillary vein
18
Q
Describe the basilic vein
A
Ascends on the medial side of the arm, passing deep at the mid-numeral level and eventually becoming the axillary vein at the lower border of theres minor
19
Q
Define a dermatome
A
An area of skin supplied by one spinal segment is called a dermatome
20
Q
Describe lymphatic drainage of upper limb
A
All lymphatic vessels from the upper limb drain into axillary nodes
21
Q
Name the 5 groups of axillary nodes
A
- Anterior or pectoral group
- Posterior of subscpaular group
- Apical group
- Central group
- Lateral or brachial group
22
Q
At which small joint do the entire upper limb and pectoral girdle
A
Sternoclavicular joint
23
Q
What type of joint is the acromioclavicukar joint
A
Synovial plane
24
Q
What type of joint is the sternoclavicular joint
A
Synovial saddle
25
Name the rhythm used when the scapular moves
Scapulo-numeral rhythm
26
State the muscles involved in scapular elevation
Trapezius
Levator scapulae
Rhomboid
27
State the muscles involved in scapular depression
Latissumus dorsi
Serrated anterior
Pectoralis
Trapezius
28
State the muscles involved in scapular protraction
Serratus anterior
| Pectoralis
29
State the muscles involved in scapular retraction
Trapezius
| rhomboid
30
State the muscles involved in lateral scapular rotation
Infraspinatus
Teres minor
Trapezius
31
State the muscles involved in medial scapular rotation
Gravity
Levator scapulae
Rhomboid
Pectoralis minor
32
What type of joint is the shoulder joint
Synovial ball and socket
33
What is the name of the ring of cartilage surrounding the socket
Glenoid labrum
34
State the role of the glenohumeral ligaments
Strengthen the stability aspect of the joint capsule
35
State the role of the transverse humeral ligament
Forms the roof of the bicipital grove
36
State the role of bursae
Act as shock absorbers
37
Name the 2 main bursa in the shoulder
Subacromial ( sub deltoid) bursa
| Subscapular bursa
38
What is the role of subacromial bursa
Reduces friction beneath deltoid, promoting free motion of the rotator cuff tendons
39
What is the movement of the subscapularis
Adductor medial rotator
40
What is the movement of the supraspinatus
Abduction
41
What is the movement of the infraspinatus
Lateral rotator of humerus
42
What is the movement of the teres minor
Adductor lateral rotator
43
What is the primary function of the rotator cuff muscles
Resting tone of muscles act to “pull” the humeral head into the glenoid fossa - additional stability
44
What do anterior fibres of deltoid do at shoulder joint
Flexion and medial rotation
45
What do middle fibres of deltoid do at shoulder joint
Abduct the arm
46
What do posterior fibres of deltoid do at shoulder joint
Extension and lateral rotation
47
What is the neve supply to deltoid
Axillary nerve
48
What is the role of the pectoralis major at the shoulder joint
Adduct the shoulder and medially rotate the humerus at the glenohumeral joint
49
What is the role of the pectoralis minor
Along with the serrratus anterior it serves to stabilise the scapula during limb movement by keeping it pulled against thoracic cage
50
What is the role of Serratus anterior
Protraction of scapula in
51
What do superior fibres of trapezius do
Elevate the scapula and rotate it during abduction
52
What do middle fibres of trapezius do
Retract the scapula
53
What do interior fibres of the trapezius do
Pull the scapula inferiorly
54
What muscles are involved in flexion of shoulder
Pectoralis major
Anterior deltoid
Coracobrachialis
55
What muscles are involved in extension of shoulder
Posterior deltoid
Latissimus dorsi
Teres major
56
What muscles are involved in adduction of shoulder joint
Pectoralis major
Lattismus dorsi
Teres major
57
What muscles are involved in abduction of shoulder joint
```
0-90°
Supraspinatus
Middle fibres of deltoid
90-180°
Trapezius
Serratus anterior
```
58
What muscles are involved in medial or internal rotation
Subscapularis
Latissimus dorsi
Pectoralis major
Teres major
59
What muscles are involved in lateral or external rotation
Infraspinatus
| Teres minor
60
Name the muscles in the anterior compartment of the arm
Brachialis
Corachobrachialis
Biceps brachii
61
What is the action of biceps brachii
Flexes shoulder and elbow joint
| Supination at superior radio-ulnar joint
62
What is the action of the coracobrachialis
Flex arm at shoulder joint
63
What is the role of the brachialis muscle
Flex the elbow joint
64
What two arteries does the brachial artery form
Radial and ulnar
65
Describe the median nerve in the arm
Arises from medial cord and lateral cord of brachial plexus
66
Describe the ulnar nerve in the arm
Arises from medial cord of brachial plexus
67
State the insertion of the common tendon of triceps
Olecranon process of ulna
68
What is the main action of triceps on elbow joint
Extension
69
Name the muscle at the elbow which aids the triceps at elbow joint
Anconeus muscle
70
What is the nerve supply to triceps and anoconeus
Radial nerve
71
What does the radial nerve innervate
All the intrinsic muscles of elbow and wrist joint
72
What is the root value of the radial nerve
C5-T1
73
What is the characteristic clinical sign of radial nerve injury
Wrist drop
74
What is the ante cubital fossa
Triangular depression or hollow lying in front of the elbow
75
What is the role of the ante cubital fossa
Acts as a conduit for passage of major neuro vascular structures from the arm down to the forarm
76
What type of joint is the elbow joint
Synovial hinge joint
77
Which ligament holds the ulnar in place
Ulnar collateral ligament (medial)
78
Which ligament holds the head of the radius
Radial collateral ligament (lateral)
79
Which muscles cause flexion of the elbow joint
Brachialis
Biceps brachii
Brachioradialis
80
What type of joints are the radio-ulnar joints
Pivot type synovial joints
81
What is the role of the radio-ulnar joint
Allow supination and pronation of the forearm
82
What ligament supports the proximal radio-ulnar joint
Annular radial ligament
83
Which muscles are involved in supination
Supinator
| Biceps brachii
84
Which muscles are involved in pronation
Pronatior quadratus
| Pronatior teres
85
what is the role of anterior compartment muscles of forearm
these muscles are flexors of the wrist and digits and facilitate pronation of the foramen at the radio-ulnar
86
what does the medial epicondyle act as
the common flexor origin for the superficial and intermediate flexors
87
which four muscles fan out from the common flexor orgiin
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
88
what is the action of pronator teres
pronates and flexes forearm
89
where does the FDS flex
wrist, metacarpophalangeal and proximal interphalangeals joints
90
what nerve innervates FDS
median nerve C7,C8,T1
91
what is the main action of the brachioradialis
weak flexion of elbow joint, maximal when forearm is in midpronated position
92
which nerve innervates the brachioradialis muscle
radial nerve, C5,C6,C7
93
what is the main action of FDP on the wrist and finger joints
flexion
94
which part of the FDP is supplied by ulnar nerve
medial part to digits 4 and 5
95
which part of the FDP is supplied by median nerve
lateral part to digits 2 and 3
96
what does pollicis mean
thumb
97
which nerve innervated the flexor pollicis longs
anterior interosseous nerve, from median nerve (C8,T1(
98
what does the pronator quadratus do
works in synergy with the proximal teres muscle and form a powerful pair of pronators at both the proximal and distal radioulnar joints
99
which muscles does the median nerve not supply in the anterior forearm
flexor carpi ulnaris and medial half of flexor digitorum profundus
100
which two arteries does the brachial artery divide into
ulnar and radial arteries at the neck of the radius
101
which arterial pulse can you feel at the distal third of forum medial to the tendon of flexor carpi radialis
radial
102
which test is used to determine the patency of the arteries in the distal forearm
Allens test
103
what is the carpal tunnel
passageway from the forearm to the hand passing deep to the flexor retinaculum
104
what is the fibrous retinaculum
a strong fibrous band which stabilises the concavity of the palmar surface of the carpus
105
what is the contents of the carpal tunnel
4 tendons of the flexor digitorum profundus
4 tendons of flexor digitorum superficialis
1 tendon of flexor pollicis longs
median nerve
106
describe carpal tunnel syndrome and the treatment
any reduction in the space within the carpal tunnel can result in weakness and tingling in the muscles and skin supplied by the median nerve.
fixed with a procedure in which the flexor retinaculum is dissected under local or general anaesthetic and the nerve is freed
107
which muscle of the forearm is continuous with the fascia of the palm
palmaris longus
108
state the 5 muscle compartments of the hand
```
thenar compartment
hypothenar compartment
lumbricals and long flexor tendons - central compartment
adductor compartment
interosseous compartment
```
109
name the three thenar muscles
abductor pollicis brevis
flexor pollicis brevis
opponents pollici
110
which nerve segments from the brachial plexus serves to provide the majority of the innervation to the thenar muscles
C8,T1
111
name the hypothenar muscles
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
112
which nerve innervates the hypothenar muscles
ulnar nerve C8,T1
113
what does opponens mean
related to the function of the muscles- contraction causes opposition - movement of the thumb or little finger towards the other fingers
114
what is the role of the lumbricals
flex the fingers at the metacarophalangeal joints and extend the interphalangeal joint of 2nd to 5th digits
115
which nerve innervates adductor pollicis
median nerve C8,T1
116
where do the interossei muscles lie
between the metacarpal bones
117
what are the actions of the interossei muscles
DAB- dorsal interossei abduct the fingers
| PAD- Palmar interossei adduct the fingers
118
which nerve innervates the dorsal and palmar intersossei muscles
ulnar nerve, C8,T1
119
which artery is the main contributor of the superificial palmar arch
ulnar artery
120
which artery is the main contributor of the deep palmar arch
radial artery
121
what is the motor supply to of the hand
median and ulnar nerves
122
what does the median nerve supply
majority of the thenar eminence apart from the deep belly of flexor pollicis braves and the 1st and 2nd lumbricals
123
what does the ulnar nerve innervate
rest of the intrinsic muscles of the hand
124
what are the spinal roots of the medial and ulnar nerve
C8 and T1
125
the ulnar nerve is a branch of which cord of the brachial plexus
medial cord
126
describe motor testing
axillary - abduct the shoulders -deltoid
musculocutaneous - flex the elbow - biceps, brachial
radial - extend the wrist - posterior compartment of forearm
ulnar - spread your fingers - intrinsic muscles of the hand
median - move your thumb towards your nose - abductor politic brevis
127
describe sensory testing
axillary - outer aspect of shoulder
radial - posterior arm, forearm and dorsal aspect of lateral 3 and a half fingers
musculocutaneous - lateral aspect of forearm
median - palmar aspect of lateral 3 and a half fingers
ulnar - palmar and dorsal aspect of medial 1 and a half fingers
128
what is the interosseous membrane
an incomplete fibrous structure, conforming stability to the forearm structure in addition to the proximal and distal and radio-ulnar joints. It is lax enough to allow supination and pronation at the radioulnar joints
129
what sits between the ulna and carpal bones
articular disc
130
what does the radius articulate with
scaphoid and lunate (carpal bones)
131
what type of fluid os found between the forearm and carpal bones
synovial fluid
132
where do the metacarpals sit
sit between the carpal bins and the phalanges, there are 5 in total
133
what are the 3 groups of muscles in the posterior forearm
1) muscles that extend and abduct or adduct the hand at the wrist joint
2) muscles that extend the medial four digits
3) muscles that extend of abduct the thumb
134
which muscles extend and abduct or adduct the hand at the wrist joint
extensor carpi radialis longus
extensor carpi radialis brevis
extensor carpi ulnaris
135
which muscles extend the medial four digits
extensor digitorum
extensor indicis
extensor digiti minimi
136
which muscles extend of abduct the thumb
abductor pollicis longus
extensor pollicis brevis
extensor politic longus
137
what is the action of the supinator
supinates forearm, rotates radius to turn palm anteriorly or superiorly
138
what is the common intervention of extensor muscles
radial nerve
139
what is the role of the deep branch of the radial nerve
main motor nerve of the extensors of the forearm
140
what is the function of the superficial branch of the radial nerve
purely sensory
141
what does extensor retinaculum provide
stability and a tunnel for the extensor tendons, which are wrapped in synovial sheaths
142
what are ganglion
non-tender cysts on the synovial sheaths found on the back of the hand
143
define anatomical snuff box
a shallow depression on the lateral aspect of the wrist when the thumb is extended fully
144
what is the medial border of the anatomical snuffbox
tendon of extensor pollicis longus
145
what is the lateral border of the anatomical snuffbox
extensor pollicis brevis and abductor pollicis longus
146
what is the floor of the anatomical snuffbox
scaphoid and trapezium
147
what is colles fracture
fracture of distal radius in which there is anterior displacement, fall onto extended wrist
148
what is smiths fracture
posterior displacement, falling into flexed wrist or direct blow to forearm
